Provider Demographics
NPI:1396965182
Name:J MICHAEL BAIRD MD PSC
Entity type:Organization
Organization Name:J MICHAEL BAIRD MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-988-1966
Mailing Address - Street 1:5 LINVILLE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2165
Mailing Address - Country:US
Mailing Address - Phone:859-988-1966
Mailing Address - Fax:859-988-1967
Practice Address - Street 1:5 LINVILLE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2165
Practice Address - Country:US
Practice Address - Phone:859-988-1966
Practice Address - Fax:859-988-1967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20827207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000527304OtherANTHEM
KY64208275Medicaid
KY64208275Medicaid